In today’s post, I wanted to provide some additional perspective on our own clinical experience with #COVID-19 here at Santa Monica Primary Care. At this writing, our point prevalence of positive testing continues to fall, now down to 11.2% (last testing date 4/7/2020) from a high of 15.5% on 3/25/2020. This is depicted in the graph below where you can see our continued decline below the trend line (in light blue).

In another clinical effort, we been identifying and formally defining “recovery” among confirmed positive cases. Taking our cue from the South Korean CDC, we have also defined “recovered” as: #1. No fever (off all medicine such as Tylenol) plus symptomatic improvement at least 7 days after a positive test and #2. Two negative confirmatory PCR tests performed within a 24 hour interval.

In our small clinical sample, we have had patients who have continued to have positive PCR tests for as few as 10 days to as long as 21 days after the start of symptoms and ranging from 8-13 days from their initial positive test. However, in all cases, viral PCR swabs for COVID-19 have ultimately returned negative. These patients have been able to be released from quarantine having met both clinical and testing criteria. This experience mirrors that of the South Korean CDC who recommend that even if viral PCR remains positive and “if a patient continues to be asymptomatic, quarantine will be lifted after three weeks of self-quarantine or isolation in a quarantine facility from the date of confirmation.”

A significant benefit to this formalized approach has been our ability to then refer patients to the American Red Cross as plasma donors. As the Red Cross notes, “People who have fully recovered from COVID-19 have antibodies in their plasma that can attack the virus. This convalescent plasma is being evaluated as treatment for patients seriously ill with COVID-19. Historically, convalescent plasma has been used as a potentially lifesaving treatment when new diseases or infections develop quickly, and no treatments or vaccines were available yet.”